7 results
Use of a cohorting-unit and systematic surveillance cultures to control a Klebsiella pneumoniae carbapenemase (KPC)–producing Enterobacteriaceae outbreak
- Allison E. Reeme, Sarah L. Bowler, Blake W. Buchan, Mary Beth Graham, Elizabeth Behrens, Siddhartha Singh, Johnny C. Hong, Jennifer Arvan, Joshua W. Hyke, Louis Palen, Sabrina Savage, Heather Seliger, Susan Huerta, Nathan A. Ledeboer, Shireen Kotay, Amy J. Mathers, Vaughn S. Cooper, Mustapha Munir Mustapha, Roberta T. Mettus, Yohei Doi, L. Silvia Munoz-Price
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 40 / Issue 7 / July 2019
- Published online by Cambridge University Press:
- 14 May 2019, pp. 767-773
- Print publication:
- July 2019
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Objective:
Describe the epidemiological and molecular characteristics of an outbreak of Klebsiella pneumoniae carbapenemase (KPC)–producing organisms and the novel use of a cohorting unit for its control.
Design:Observational study.
Setting:A 566-room academic teaching facility in Milwaukee, Wisconsin.
Patients:Solid-organ transplant recipients.
Methods:Infection control bundles were used throughout the time of observation. All KPC cases were intermittently housed in a cohorting unit with dedicated nurses and nursing aids. The rooms used in the cohorting unit had anterooms where clean supplies and linens were placed. Spread of KPC-producing organisms was determined using rectal surveillance cultures on admission and weekly thereafter among all consecutive patients admitted to the involved units. KPC-positive strains underwent pulsed-field gel electrophoresis and whole-genome sequencing.
Results:A total of 8 KPC cases (5 identified by surveillance) were identified from April 2016 to April 2017. After the index patient, 3 patients acquired KPC-producing organisms despite implementation of an infection control bundle. This prompted the use of a cohorting unit, which immediately halted transmission, and the single remaining KPC case was transferred out of the cohorting unit. However, additional KPC cases were identified within 2 months. Once the cohorting unit was reopened, no additional KPC cases occurred. The KPC-positive species identified during this outbreak included Klebsiella pneumoniae, Enterobacter cloacae complex, and Escherichia coli. blaKPC was identified on at least 2 plasmid backbones.
Conclusions:A complex KPC outbreak involving both clonal and plasmid-mediated dissemination was controlled using weekly surveillances and a cohorting unit.
Validity and calibration of the FFQ used in the Melbourne Collaborative Cohort Study
- Julie K Bassett, Dallas R English, Michael T Fahey, Andrew B Forbes, Lyle C Gurrin, Julie A Simpson, Maree T Brinkman, Graham G Giles, Allison M Hodge
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- Journal:
- Public Health Nutrition / Volume 19 / Issue 13 / September 2016
- Published online by Cambridge University Press:
- 14 April 2016, pp. 2357-2368
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Objective
To evaluate the reliability and validity of the FFQ administered to participants in the follow-up of the Melbourne Collaborative Cohort Study (MCCS), and to provide calibration coefficients.
DesignA random sample stratified by country of birth, age, sex and BMI was selected from MCCS participants. Participants completed two FFQ and three 24 h recalls over 1 year. Reliability was evaluated by intraclass correlation coefficients (ICC). Validity coefficients (VC) were estimated from structural equation models and calibration coefficients obtained from regression calibration models.
SettingAdults born in Australia, Greece or Italy.
SubjectsNine hundred and sixty-five participants consented to the study; of these, 459 participants were included in the reliability analyses and 615 in the validity and calibration analyses.
ResultsThe FFQ showed good repeatability for twenty-three nutrients with ICC ranging from 0·66 to 0·80 for absolute nutrient intakes for Australian-born and from 0·51 to 0·74 for Greek/Italian-born. For Australian-born, VC ranged from 0·46 (monounsaturated fat) to 0·83 (Ca) for nutrient densities, comparing well with other studies. For Greek/Italian-born, VC were between 0·21 (Na) and 0·64 (riboflavin). Calibration coefficients for nutrient densities ranged from 0·39 (retinol) to 0·74 (Mg) for Australian-born and from 0·18 (Zn) to 0·54 (riboflavin) for Greek/Italian-born.
ConclusionsThe FFQ used in the MCCS follow-up study is suitable for estimating energy-adjusted nutrients for Australian-born participants. However, its performance for estimating intakes is poorer for southern European migrants and alternative dietary assessment methods ought to be considered if dietary data are to be measured in similar demographic groups.
Contributors
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- By Mitchell Aboulafia, Frederick Adams, Marilyn McCord Adams, Robert M. Adams, Laird Addis, James W. Allard, David Allison, William P. Alston, Karl Ameriks, C. Anthony Anderson, David Leech Anderson, Lanier Anderson, Roger Ariew, David Armstrong, Denis G. Arnold, E. J. Ashworth, Margaret Atherton, Robin Attfield, Bruce Aune, Edward Wilson Averill, Jody Azzouni, Kent Bach, Andrew Bailey, Lynne Rudder Baker, Thomas R. Baldwin, Jon Barwise, George Bealer, William Bechtel, Lawrence C. Becker, Mark A. Bedau, Ernst Behler, José A. Benardete, Ermanno Bencivenga, Jan Berg, Michael Bergmann, Robert L. Bernasconi, Sven Bernecker, Bernard Berofsky, Rod Bertolet, Charles J. Beyer, Christian Beyer, Joseph Bien, Joseph Bien, Peg Birmingham, Ivan Boh, James Bohman, Daniel Bonevac, Laurence BonJour, William J. Bouwsma, Raymond D. Bradley, Myles Brand, Richard B. Brandt, Michael E. Bratman, Stephen E. Braude, Daniel Breazeale, Angela Breitenbach, Jason Bridges, David O. Brink, Gordon G. Brittan, Justin Broackes, Dan W. Brock, Aaron Bronfman, Jeffrey E. Brower, Bartosz Brozek, Anthony Brueckner, Jeffrey Bub, Lara Buchak, Otavio Bueno, Ann E. Bumpus, Robert W. Burch, John Burgess, Arthur W. Burks, Panayot Butchvarov, Robert E. Butts, Marina Bykova, Patrick Byrne, David Carr, Noël Carroll, Edward S. Casey, Victor Caston, Victor Caston, Albert Casullo, Robert L. Causey, Alan K. L. Chan, Ruth Chang, Deen K. Chatterjee, Andrew Chignell, Roderick M. Chisholm, Kelly J. Clark, E. J. Coffman, Robin Collins, Brian P. Copenhaver, John Corcoran, John Cottingham, Roger Crisp, Frederick J. Crosson, Antonio S. Cua, Phillip D. Cummins, Martin Curd, Adam Cureton, Andrew Cutrofello, Stephen Darwall, Paul Sheldon Davies, Wayne A. Davis, Timothy Joseph Day, Claudio de Almeida, Mario De Caro, Mario De Caro, John Deigh, C. F. Delaney, Daniel C. Dennett, Michael R. DePaul, Michael Detlefsen, Daniel Trent Devereux, Philip E. Devine, John M. Dillon, Martin C. Dillon, Robert DiSalle, Mary Domski, Alan Donagan, Paul Draper, Fred Dretske, Mircea Dumitru, Wilhelm Dupré, Gerald Dworkin, John Earman, Ellery Eells, Catherine Z. Elgin, Berent Enç, Ronald P. Endicott, Edward Erwin, John Etchemendy, C. Stephen Evans, Susan L. Feagin, Solomon Feferman, Richard Feldman, Arthur Fine, Maurice A. Finocchiaro, William FitzPatrick, Richard E. Flathman, Gvozden Flego, Richard Foley, Graeme Forbes, Rainer Forst, Malcolm R. Forster, Daniel Fouke, Patrick Francken, Samuel Freeman, Elizabeth Fricker, Miranda Fricker, Michael Friedman, Michael Fuerstein, Richard A. Fumerton, Alan Gabbey, Pieranna Garavaso, Daniel Garber, Jorge L. A. Garcia, Robert K. Garcia, Don Garrett, Philip Gasper, Gerald Gaus, Berys Gaut, Bernard Gert, Roger F. Gibson, Cody Gilmore, Carl Ginet, Alan H. Goldman, Alvin I. Goldman, Alfonso Gömez-Lobo, Lenn E. Goodman, Robert M. Gordon, Stefan Gosepath, Jorge J. E. Gracia, Daniel W. Graham, George A. Graham, Peter J. Graham, Richard E. Grandy, I. Grattan-Guinness, John Greco, Philip T. Grier, Nicholas Griffin, Nicholas Griffin, David A. Griffiths, Paul J. Griffiths, Stephen R. Grimm, Charles L. Griswold, Charles B. Guignon, Pete A. Y. Gunter, Dimitri Gutas, Gary Gutting, Paul Guyer, Kwame Gyekye, Oscar A. Haac, Raul Hakli, Raul Hakli, Michael Hallett, Edward C. Halper, Jean Hampton, R. James Hankinson, K. R. Hanley, Russell Hardin, Robert M. Harnish, William Harper, David Harrah, Kevin Hart, Ali Hasan, William Hasker, John Haugeland, Roger Hausheer, William Heald, Peter Heath, Richard Heck, John F. Heil, Vincent F. Hendricks, Stephen Hetherington, Francis Heylighen, Kathleen Marie Higgins, Risto Hilpinen, Harold T. Hodes, Joshua Hoffman, Alan Holland, Robert L. Holmes, Richard Holton, Brad W. Hooker, Terence E. Horgan, Tamara Horowitz, Paul Horwich, Vittorio Hösle, Paul Hoβfeld, Daniel Howard-Snyder, Frances Howard-Snyder, Anne Hudson, Deal W. Hudson, Carl A. Huffman, David L. Hull, Patricia Huntington, Thomas Hurka, Paul Hurley, Rosalind Hursthouse, Guillermo Hurtado, Ronald E. Hustwit, Sarah Hutton, Jonathan Jenkins Ichikawa, Harry A. Ide, David Ingram, Philip J. Ivanhoe, Alfred L. Ivry, Frank Jackson, Dale Jacquette, Joseph Jedwab, Richard Jeffrey, David Alan Johnson, Edward Johnson, Mark D. Jordan, Richard Joyce, Hwa Yol Jung, Robert Hillary Kane, Tomis Kapitan, Jacquelyn Ann K. Kegley, James A. Keller, Ralph Kennedy, Sergei Khoruzhii, Jaegwon Kim, Yersu Kim, Nathan L. King, Patricia Kitcher, Peter D. Klein, E. D. Klemke, Virginia Klenk, George L. Kline, Christian Klotz, Simo Knuuttila, Joseph J. Kockelmans, Konstantin Kolenda, Sebastian Tomasz Kołodziejczyk, Isaac Kramnick, Richard Kraut, Fred Kroon, Manfred Kuehn, Steven T. Kuhn, Henry E. Kyburg, John Lachs, Jennifer Lackey, Stephen E. Lahey, Andrea Lavazza, Thomas H. Leahey, Joo Heung Lee, Keith Lehrer, Dorothy Leland, Noah M. Lemos, Ernest LePore, Sarah-Jane Leslie, Isaac Levi, Andrew Levine, Alan E. Lewis, Daniel E. Little, Shu-hsien Liu, Shu-hsien Liu, Alan K. L. Chan, Brian Loar, Lawrence B. Lombard, John Longeway, Dominic McIver Lopes, Michael J. Loux, E. J. Lowe, Steven Luper, Eugene C. Luschei, William G. Lycan, David Lyons, David Macarthur, Danielle Macbeth, Scott MacDonald, Jacob L. Mackey, Louis H. Mackey, Penelope Mackie, Edward H. Madden, Penelope Maddy, G. B. Madison, Bernd Magnus, Pekka Mäkelä, Rudolf A. Makkreel, David Manley, William E. Mann (W.E.M.), Vladimir Marchenkov, Peter Markie, Jean-Pierre Marquis, Ausonio Marras, Mike W. Martin, A. P. Martinich, William L. McBride, David McCabe, Storrs McCall, Hugh J. McCann, Robert N. McCauley, John J. McDermott, Sarah McGrath, Ralph McInerny, Daniel J. McKaughan, Thomas McKay, Michael McKinsey, Brian P. McLaughlin, Ernan McMullin, Anthonie Meijers, Jack W. Meiland, William Jason Melanson, Alfred R. Mele, Joseph R. Mendola, Christopher Menzel, Michael J. Meyer, Christian B. Miller, David W. Miller, Peter Millican, Robert N. Minor, Phillip Mitsis, James A. Montmarquet, Michael S. Moore, Tim Moore, Benjamin Morison, Donald R. Morrison, Stephen J. Morse, Paul K. Moser, Alexander P. D. Mourelatos, Ian Mueller, James Bernard Murphy, Mark C. Murphy, Steven Nadler, Jan Narveson, Alan Nelson, Jerome Neu, Samuel Newlands, Kai Nielsen, Ilkka Niiniluoto, Carlos G. Noreña, Calvin G. Normore, David Fate Norton, Nikolaj Nottelmann, Donald Nute, David S. Oderberg, Steve Odin, Michael O’Rourke, Willard G. Oxtoby, Heinz Paetzold, George S. Pappas, Anthony J. Parel, Lydia Patton, R. P. Peerenboom, Francis Jeffry Pelletier, Adriaan T. Peperzak, Derk Pereboom, Jaroslav Peregrin, Glen Pettigrove, Philip Pettit, Edmund L. Pincoffs, Andrew Pinsent, Robert B. Pippin, Alvin Plantinga, Louis P. Pojman, Richard H. Popkin, John F. Post, Carl J. Posy, William J. Prior, Richard Purtill, Michael Quante, Philip L. Quinn, Philip L. Quinn, Elizabeth S. Radcliffe, Diana Raffman, Gerard Raulet, Stephen L. Read, Andrews Reath, Andrew Reisner, Nicholas Rescher, Henry S. Richardson, Robert C. Richardson, Thomas Ricketts, Wayne D. Riggs, Mark Roberts, Robert C. Roberts, Luke Robinson, Alexander Rosenberg, Gary Rosenkranz, Bernice Glatzer Rosenthal, Adina L. Roskies, William L. Rowe, T. M. Rudavsky, Michael Ruse, Bruce Russell, Lilly-Marlene Russow, Dan Ryder, R. M. Sainsbury, Joseph Salerno, Nathan Salmon, Wesley C. Salmon, Constantine Sandis, David H. Sanford, Marco Santambrogio, David Sapire, Ruth A. Saunders, Geoffrey Sayre-McCord, Charles Sayward, James P. Scanlan, Richard Schacht, Tamar Schapiro, Frederick F. Schmitt, Jerome B. Schneewind, Calvin O. Schrag, Alan D. Schrift, George F. Schumm, Jean-Loup Seban, David N. Sedley, Kenneth Seeskin, Krister Segerberg, Charlene Haddock Seigfried, Dennis M. Senchuk, James F. Sennett, William Lad Sessions, Stewart Shapiro, Tommie Shelby, Donald W. Sherburne, Christopher Shields, Roger A. Shiner, Sydney Shoemaker, Robert K. Shope, Kwong-loi Shun, Wilfried Sieg, A. John Simmons, Robert L. Simon, Marcus G. Singer, Georgette Sinkler, Walter Sinnott-Armstrong, Matti T. Sintonen, Lawrence Sklar, Brian Skyrms, Robert C. Sleigh, Michael Anthony Slote, Hans Sluga, Barry Smith, Michael Smith, Robin Smith, Robert Sokolowski, Robert C. Solomon, Marta Soniewicka, Philip Soper, Ernest Sosa, Nicholas Southwood, Paul Vincent Spade, T. L. S. Sprigge, Eric O. Springsted, George J. Stack, Rebecca Stangl, Jason Stanley, Florian Steinberger, Sören Stenlund, Christopher Stephens, James P. Sterba, Josef Stern, Matthias Steup, M. A. Stewart, Leopold Stubenberg, Edith Dudley Sulla, Frederick Suppe, Jere Paul Surber, David George Sussman, Sigrún Svavarsdóttir, Zeno G. Swijtink, Richard Swinburne, Charles C. Taliaferro, Robert B. Talisse, John Tasioulas, Paul Teller, Larry S. Temkin, Mark Textor, H. S. Thayer, Peter Thielke, Alan Thomas, Amie L. Thomasson, Katherine Thomson-Jones, Joshua C. Thurow, Vzalerie Tiberius, Terrence N. Tice, Paul Tidman, Mark C. Timmons, William Tolhurst, James E. Tomberlin, Rosemarie Tong, Lawrence Torcello, Kelly Trogdon, J. D. Trout, Robert E. Tully, Raimo Tuomela, John Turri, Martin M. Tweedale, Thomas Uebel, Jennifer Uleman, James Van Cleve, Harry van der Linden, Peter van Inwagen, Bryan W. Van Norden, René van Woudenberg, Donald Phillip Verene, Samantha Vice, Thomas Vinci, Donald Wayne Viney, Barbara Von Eckardt, Peter B. M. Vranas, Steven J. Wagner, William J. Wainwright, Paul E. Walker, Robert E. Wall, Craig Walton, Douglas Walton, Eric Watkins, Richard A. Watson, Michael V. Wedin, Rudolph H. Weingartner, Paul Weirich, Paul J. Weithman, Carl Wellman, Howard Wettstein, Samuel C. Wheeler, Stephen A. White, Jennifer Whiting, Edward R. Wierenga, Michael Williams, Fred Wilson, W. Kent Wilson, Kenneth P. Winkler, John F. Wippel, Jan Woleński, Allan B. Wolter, Nicholas P. Wolterstorff, Rega Wood, W. Jay Wood, Paul Woodruff, Alison Wylie, Gideon Yaffe, Takashi Yagisawa, Yutaka Yamamoto, Keith E. Yandell, Xiaomei Yang, Dean Zimmerman, Günter Zoller, Catherine Zuckert, Michael Zuckert, Jack A. Zupko (J.A.Z.)
- Edited by Robert Audi, University of Notre Dame, Indiana
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- The Cambridge Dictionary of Philosophy
- Published online:
- 05 August 2015
- Print publication:
- 27 April 2015, pp ix-xxx
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Does feeding area restriction inhibit social learning of toxic weed ingestion in cattle?
- K. T. Jackson, A. F. Cibils, W. R. Gould, J. D. Graham, C. D. Allison
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Social learning from peers can trigger herd-wide intoxication with white locoweed (Oxytropis sericea), an alkaloid-synthesizing herbaceous legume that grows on rangelands of western North America. We conducted an experiment to test the hypothesis that restriction of the area allocated to animals to feed in would inhibit social facilitation of locoweed ingestion in yearling heifers. Eight heifers that avoided white locoweed (LA) and eight heifers that readily consumed it (LE) were selected from a pool of 40 cross-bred heifers and were randomly assigned to the social facilitation or social interference treatment groups. We conducted 200 10-min feeding trials in three 5-day phases (pre-treatment, treatment, post-treatment) during which animals were presented with a set of bowls arrayed in a test arena, some of which contained ground wheat straw and others contained air-dried ground white locoweed. During the pre-treatment (days 1 to 5) and the post-treatment phases (days 11 to 15) non-social trials were conducted in which the feeding behavior of individual animals was investigated in an 80 m2 arena containing 12 feeding bowls. During the treatment phase (days 6 to 10) social learning trials were conducted in which LA + LE pairs from the social interference group were exposed to 12 bowls of food distributed in an 80 m2 arena intended to induce social interference, and LA + LE pairs from the social facilitation group were exposed to 36 bowls of food distributed in a 240 m2 arena intended to permit social facilitation. During pre-treatment phase, LA heifers consumed detectably less locoweed and wheat straw and exhibited lower preference for locoweed than LE (P ⩽ 0.05) although wheat straw preference of LA and LE was similar. During social learning trials (treatment phase), LA in the social interference group visited similar number of locoweed bowls (mean ± s.e.m.: 0.2 ± 0.12) as they had during non-social learning (0.2 ± 0.20). Conversely, LA heifers in the social facilitation group visited detectably more locoweed bowls during social learning trials (1.6 ± 0.46) compared with the pre-treatment phase (0.2 ± 0.16). Correlation between daily number of locoweed bowls visited by LA and LE during social learning trials was detected in the social facilitation (r = 0.70; P < 0.01), but not in the social interference group (r = 0.15; P = 0.52). During testing trials (post-treatment phase), locoweed and wheat straw intake and preference of LA and LE in both treatment groups was similar. Manipulation of the feeding environment delayed, but did not inhibit social learning of toxic weed ingestion in this study.
Bureaucratic Politics: A Paradigm and Some Policy Implications
- Graham T. Allison, Morton H. Halperin
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- Journal:
- World Politics / Volume 24 / Issue S1 / Spring 1972
- Published online by Cambridge University Press:
- 18 July 2011, pp. 40-79
- Print publication:
- Spring 1972
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During the Tet holiday of 1968, North Vietnamese troops launched massive attacks on a large number of South Vietnamese cities. Why?
Conceptual Models and the Cuban Missile Crisis*
- Graham T. Allison
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- American Political Science Review / Volume 63 / Issue 3 / November 1969
- Published online by Cambridge University Press:
- 01 August 2014, pp. 689-718
- Print publication:
- November 1969
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The Cuban missile crisis is a seminal event. For thirteen days of October 1962, there was a higher probability that more human lives would end suddenly than ever before in history. Had the worst occurred, the death of 100 million Americans, over 100 million Russians, and millions of Europeans as well would make previous natural calamities and inhumanities appear insignificant. Given the probability of disaster—which President Kennedy estimated as “between 1 out of 3 and even”—our escape seems awesome. This event symbolizes a central, if only partially thinkable, fact about our existence. That such consequences could follow from the choices and actions of national governments obliges students of government as well as participants in governance to think hard about these problems.
Improved understanding of this crisis depends in part on more information and more probing analyses of available evidence. To contribute to these efforts is part of the purpose of this study. But here the missile crisis serves primarily as grist for a more general investigation.
This study proceeds from the premise that marked improvement in our understanding of such events depends critically on more self-consciousness about what observers bring to the analysis. What each analyst sees and judges to be important is a function not only of the evidence about what happened but also of the “conceptual lenses” through which he looks at the evidence. The principal purpose of this essay is to explore some of the fundamental assumptions and categories employed by analysts in thinking about problems of governmental behavior, especially in foreign and military affairs.
Conceptual Models and the Cuban Missile Crisis*
- Graham T. Allison
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- Journal:
- American Political Science Review / Volume 63 / Issue 3 / November 1969
- Published online by Cambridge University Press:
- 21 September 2012, pp. 689-718
- Print publication:
- November 1969
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The Cuban missile crisis is a seminal event. For thirteen days of October 1962, there was a higher probability that more human lives would end suddenly than ever before in history. Had the worst occurred, the death of 100 million Americans, over 100 million Russians, and millions of Europeans as well would make previous natural calamities and inhumanities appear insignificant. Given the probability of disaster—which President Kennedy estimated as “between 1 out of 3 and even”—our escape seems awesome. This event symbolizes a central, if only partially thinkable, fact about our existence. That such consequences could follow from the choices and actions of national governments obliges students of government as well as participants in governance to think hard about these problems.
Improved understanding of this crisis depends in part on more information and more probing analyses of available evidence. To contribute to these efforts is part of the purpose of this study. But here the missile crisis serves primarily as grist for a more general investigation. This study proceeds from the premise that marked improvement in our understanding of such events depends critically on more self-consciousness about what observers bring to the analysis. What each analyst sees and judges to be important is a function not only of the evidence about what happened but also of the “conceptual lenses” through which he looks at the evidence. The principal purpose of this essay is to explore some of the fundamental assumptions and categories employed by analysts in thinking about problems of governmental behavior, especially in foreign and military affairs.